People with phobias, particularly social phobia, may also have problems with substance abuse. Many people with social or a specific phobia become so anxious that they experience panic attacks, which are intense and unexpected bursts of terror accompanied by physical symptoms.
As more situational panic attacks occur, people with phobias may take extreme measures to avoid situations where they fear another attack might happen or where help would not be immediately available. This avoidance, similar to that in many panic disorder patients, may eventually develop into agoraphobia, an inability to go beyond known and safe surroundings because of intense fear and anxiety. Appropriate diagnosis and treatment of other disorders are important to the successful treatment of phobias.
The fear of being alone or in a public place that has no escape hatch (such as a public bus), is the most disabling because victims can become housebound. The illness can begin any time from late childhood through early adulthood and, left untreated, worsens with time.
“I’m scared to death of flying, and I never do it anymore. It’s an awful feeling when that airplane door closes and I feel trapped. My heart pounds, and I sweat bullets. If somebody starts talking to me, I get very stiff and preoccupied”.
“When the airplane starts to ascend, it just reinforces that feeling that I can’t get out. I picture myself losing control, freaking out, climbing the walls, but ofcourse I never do. I’m not afraid of crashing or hitting turbulence. It’s just that feeling of being trapped”. “Whenever I’ve thought about changing jobs, I’ve had to think, “Would I be under pressure to fly?” These days, I only go to places where I can drive or take a train. My friends always point out that I couldn’t get off a train traveling at high speeds either, so why don’t trains bother me? I just tell them it isn’t a rational fear”.
Many people experience specific phobias, intense, irrational fears of certain things or situations – dogs, closed–in places, heights, escalators, tunnels, highway driving, water, flying and injuries involving blood are a few of the more common ones.
Phobias aren’t just extreme fear, they are irrational fears. You may be able to ski the world’s tallest mountains with ease but panic going above the 10th floor of an office building. Adults with phobias realize their fears are irrational, but often facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety.
Specific phobias strike more than 1 in 10 people. No one knows just what causes them, though they seem to run in families and are a little more prevalent in women. Phobias usually first appear in adolescence or adulthood. They start suddenly and tend to be more persistent than childhood phobias, only about 20 per cent of adult phobias vanish on their own.
When children have specific phobias – for example, a fear of animals – those fears usually disappear over time, though some may continue into adulthood. No one knows why they stay on in some people and disappear in others.
If the object of the fear is easy to avoid, people with phobias may not feel the need to seek treatment. Sometimes, though, they may make important career or personal decisions to avoid a phobic situation. When phobias interfere with a person’s life, treatment can help. Successful treatment usually involves a kind of cognitive–behavioral therapy called ‘Desensitization or exposure therapy’, in which patients are gradually exposed to what frightens them until the fear begins to fade. Three–fourths of patients benefit significantly from this type of treatment. Relaxation and breathing exercises also help reduce anxiety symptoms.
There is currently no proven drug treatment for specific phobias, but sometimes certain medications may be prescribed to help reduce anxiety symptoms before someone faces a phobic situation.